多药学的隐藏风险:通过STOPP/START标准版本3-A横截面研究探索可能不合适的处方
Mikołaj Szoszkiewicz1, Ewa Deskur-Śmielecka2, Arkadiusz Styszyński2
1Department of Palliative Medicine, Poznan University of Medical Sciences, Doctoral School, Geriatric Unit, Poznan, Poland.
PloS one
|December 18, 2025
概括
潜在不合适的药物 (PIM) 和处方遗漏 (PPO) 影响超过70%的多药老年人. 像STOPP/START v3这样的工具对于优化老年人药物治疗和降低风险至关重要.
科学领域:
- 老年医学 老年医学
- 临床药房 临床药房
- 药理疗优化药理疗的优化
背景情况:
- 多药性和不适当的处方是老年护理的重大挑战,增加了不良药物事件,住院和成本.
- 更新的STOPP/START版本3标准为老年人提供了一种改进的方法来识别可能不合适的药物 (PIM) 和潜在的处方遗漏 (PPO).
研究的目的:
- 评估部分依赖的多药老年患者中PIM和PPO的患病率.
- 在这个人群中确定与处方不适当性相关的因素.
主要方法:
- 一项回顾性,横截面研究,涉及来自波兰两个日托中心的296名患者.
- 使用STOPP/START版本3标准,在服用≥5种药物的患者中识别PIM和PPO.
- 分析数据以确定影响不适当处方的因素.
主要成果:
- STOPP版本3在73.6%的参与者中发现了PIM,通常涉及止痛药和心血管问题的阿司匹林.
- 在78.7%的患者中,START版本3检测到PPO,心血管治疗和药最常被遗漏.
- 与PIM相关的因素包括药物数量,抑郁症和跌倒;PPO与多病症,药物数量,心力衰竭,CAD,BPH和抑郁症有关.
结论:
- PIM和PPO的高患病率强调了使用STOPP/START v3等工具的必要性,以优化老年人药物治疗.
- 不适当的处方往往涉及较新的药物和最近的基于证据的药物更新,强调需要持续的临床审查.
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